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Öğe Boyun travması: migrate yabancı cisim(2019) Taş, Burak Mustafa; Şimşek, Gökce; Daphan, Çağatay; Öğden, Mustafa; Gültekin, Yıldırım; Kılıç, RahmiBoyunda yabancı cisim olguları iyatrojenik veya travmatik olabilirler. Ateşli silah yaralanmaları, kesici-delici alet yaralanmaları ile oluşan olgular bunlara örnek gösterilebilir. Büyük arter ve venler, trakea ve nöral yapılar hasara uğrayabilir. Yabancı cismin boyun yapıları ve fasiyaları içerisinde migrate olması nadir ancak beklenen bir durumdur. Bu yüzden yabancı cisimler beklenmedik yerlerde bulunabilir. Bizim olgumuzda 37 yaşında erkek hasta boyunda birçok kesi ve yabancı cisim nedeniyle tarafımıza danışıldı. Hastanın radyolojik görüntülemesinde servikal vertebra anteriorunda yabancı cisim izlendi ve acil ameliyata alındı. Migrate olan yabancı cisim operasyon sonrasında hastanın nazofarenksinde bulundu ve çıkarıldı. Kulak-Burun-Boğaz hekimliği pratiğinde karşımıza çıkabilecek olan boyunda yabancı cisimlere vital yapılara yakınlığı nedeniyle dikkat edilmelidir.Öğe Effect of Carnitine on Cutaneous Wound Healing in Immunosuppressed Rats(Academic Press Inc Elsevier Science, 2009) Akkuş, Abdullah; Aydınuraz, Kuzey; Daphan, Çağatay; Saygun, Oral; çağlayan, Osman; Edremitlioğlu, Mustafa; Ağalar, FatihBackground. The wound is ischemic in nature. Chronic steroid administration impairs wound healing by changing enzymes in the glycolytic pathway. Carnitine supplementation may help to restore the energy deficiency caused by chronic steroid administration in the wound. The aim of this study was to evaluate the effect of carnitine on impaired wound healing. Methods. The study was conducted in three groups. Surgical intervention was a 4 cm long midline skin incision at the back. In Group A, eight rats received methylprednisolone for 7 d prior to surgical intervention, and it was continued until the end of the experiment. In Group B, 12 rats received methylprednisolone for 7 d prior to surgical intervention. After surgery, methylprednisolone injection was continued and carnitine was supplemented until the end of the experiment. In Group C, eight rats received no medication. The wound of half of the animals in each group was harvested on the seventh day after surgical intervention and the remaining on the 14th d. Tensile strength and hydroxyproline content were measured in all groups. Results. There was no significant difference in parameters in any of the groups on day seven. On day 14, all parameters were statistically different between methylprednisolone and control groups (P < 0.05). Values for tensile strength were higher in the methylprednisolone/carnitine group compared with methylprednisolone group (P < 0.05). Carnitine administration had also increased hydroxyproline levels in the methylprednisolone/carnitine group compared with the control group (P < 0.05). Conclusions. Carnitine is shown to increase tensile strength of the wound when supplemented to immunosuppressed rats in which wound healing is impaired by methylprednisolone. (C) 2009 Elsevier Inc. All rights reserved.Öğe The effect of G-CSF in an experimental MRSA graft infection in mice(Taylor & Francis Inc, 2005) Ağalar, Canan; Eroğlu, Erol; Sari, Mustafa; Sari, Aliye; Daphan, Çağatay; Ağalar, FatihWound infection after prosthetic material implantation is a troublesome complication with an incidence of 2% to 10%. The effect of granulocyte colony-stimulating factor (G-CSF) was studied in an experimental methicillin-resistant Staphylococcus aureus (MRSA) graft infection model. Eighty adult mice were used. Under general anesthesia an abdominal incision of 2 cm in length was performed. A subcutaneous cavity of 2 x 2 cm in size was created. Polypropylene mesh pieces of 2 x 1 cm and MRSA solution of 0.1 ml of 10(8) CFU/mL were used. G-CSF was applied systemically or locally in a dosage of 0.02 MU/30 g body weight. There were 8 groups: group I, wound + MRSA; group II, wound + mesh + MRSA; group III, wound + mesh + MRSA + G-CSF (ip, 48 h before operation); group IV, wound + mesh + MRSA + G-CSF (ip, 24 h before operation); group V, wound + mesh + MRSA + G-CSF (locally, into the cavity); group VI, wound + mesh (incubated in G-CSF solution for 4 h) + MRSA; group VII, wound + mesh + MRSA + G-CSF, ip, 24 h from operation; and group VIII (positive control group), wound + mesh + MRSA + Teicoplanin (0.03 mg/30 g body weight, ip, 1/2 h before operation). Three days after, animals were killed and incisions were examined for possible infection or abscess formation and wound failure. Meshes were removed; after vortexing and dilution, samples were incubated with 5% agar media. Results of bacterial incubation were evaluated 24 h and 48 h later. There were symptoms of wound infection and abscess formation in all groups except group VIII. In group VIII, MRSA was isolated in 7 events with a colony count below 10(3). Bacterial counts were above 106 (10(6)-10(8)) in all other groups. Thus, it was observed that wound infection could be created with this model, but G-CSF could not prevent the development of wound infection, whether it was administered systemically or locally. Teicoplanin decreased the number of colony-forming units of MRSA, and prevents wound infection in this MRSA wound infection model.Öğe The Effect of Simvastatin on Pulmonary Damage in Experimental Peritonitis in Rats(Springer India, 2015) Altunal, Çetin; Ağalar, Fatih; Ağalar, Canan; Daphan, Çağatay; Saygun, Oral; Aydınuraz, Kuzey; Dom, SedatStatins are widely used in the treatment of hyperlipidemia, as they inhibit cholesterol synthesis. They also have anti-inflammatory, antioxidant, immunomodulatory, and positive endothelial-functional effects. It is hypothesized that simvastatin ameliorates pulmonary damage secondary to peritonitis in rats. Forty Wistar albino rats were divided into four groups. In sham group, laparotomy was the standard procedure. In simvastatin group, simvastatin was given perorally before laparotomy. In sepsis group, peritoneal sepsis was constituted by cecal ligation and puncture technique. In sepsis+simvastatin group, the procedures of simvastatin and sepsis groups were applied together. After sacrification at the 72nd hour, tissue samples from lungs were harvested for histopathological examination, wet and dry weight measurements, and tissue culture, tissue malondialdehyde, and nitric oxide tests. Blood samples were taken for C-reactive protein and whole blood count. While the malondialdehyde levels were found to be significantly higher in sepsis group, nitric oxide levels were found to be significantly lower in simvastatin+sepsis group. Alveolar hemorrhage was highest in simvastatin+sepsis group. There was no difference for C-reactive protein, leukocyte levels, and histopathological examination between any groups. The ratios of wet and dry lung weights were higher in simvastatin-given groups. Simvastatin has no positive effect in terms of lung dysfunction on experimental sepsis model. For a better understanding of the effects of simvastatin on lung injury in peritoneal sepsis, experimental models of longer duration that enable to search the effects of simvastatin beyond 3 days will be more useful.Öğe Effects of different anesthetic techniques on serum leptin, C-reactive protein, and cortisol concentrations in anorectal surgery(Medicinska Naklada, 2006) Büyükkoçak, Ünase; Daphan, Çağatay; Çağlayan, Osman; Aydinuraz, Kuzey; Kaya, Tahsin; Saygun, Oral; Ağalar, FatihAim To compare the effects of intratracheal general anesthesia (ITGA) and regional (saddle block) anesthesia on leptin, C-reactive protein (CRP), and cortisol blood concentrations during anorectal surgery. Methods Fifty-eight patients suffering from hemorrhoidal disease, pilonidal sinus, anal fissure, or anal fistula were included the study. Patients were randomly assigned into one of the two groups (n = 29). Patients in one group received ITGA. After thiopental and fentanyl induction, vecuronium was used as a muscle relaxant. Anesthesia was maintained with sevoflurane. In the other group we applied saddle block, injecting hyperbaric bupivacaine into the subarachnoid space, through the L3-L4 intervertebral space, in the sitting position. Blood samples were collected for leptin, CRP, and cortisol analysis before the induction of anesthesia at 3 and 24 hours postoperatively. Results Preoperative leptin, CRP, and cortisol concentrations were comparable between the groups. There was no significant difference in postoperative levels of leptin and CRP in both groups. Although not significant, leptin and CRP concentrations were lower in the saddle block group at three hours postoperatively (mean SD, 6.95 +/- 8.59 and 6.02 +/- 12.25, respectively) than in the ITGA group (mean SD, 9.04 +/- 9.89 and 8.40 +/- 15.75, respectively). During early postoperative period, cortisol increased slightly in the ITGA group and remained at similar level in the saddle block group, but later decreased in both groups. Cortisol levels in the saddle block group were significantly lower than in the ITGA group at 3 hours postoperatively (343.7 +/- 329.6 vs 611.4 +/- 569.8; P = 0.034). Conclusion Saddle block, a regional anesthetic technique, may attenuate stress response in patients undergoing anorectal surgery, by blocking afferent neural input during early postoperative period.Öğe Gold and gold-palladium coated polypropylene grafts in a S-epidermidis wound infection model(Academic Press Inc Elsevier Science, 2006) Saygun, Oral; Ağalar, Canan; Aydınuraz, Kuzey; Ağalar, Fatih; Daphan, Çağatay; Saygun, Meral; Denkbaş, Emir BakiBackground. The use of non-absorbable mesh grafts in both abdominal wall defects and inguinal hernias are impossible in the presence of contamination. This study was conducted for evaluation of the efficiencies of polypropylene mesh grafts coated with gold and palladium-gold. Materials and methods. Ten piece of 1 x 2 cm. of polypropylene mesh grafts were used in each group of naive, gold-coated, and palladium-gold-coated. The grafts were incubated in physiological saline buffered and 0.5 McFarland slime positive Staphylococcus epidermidis for 24 h. At intervals of 6,12,24,48, 72 h grafts were washed with saline and vortexed for 2 min in 2 ml of physiological saline. There were 100 mu l of samples of vortexed material incubated in blood agar and 24 h later, colony numbers were assessed. In the second part of study, the grafts were implanted below the musculoaponeurotic layer at inguinal. region of rats following the same procedure of incubation and washing. On the 8th day, the rats were examined for infection rate and their wound cultures were obtained. Results. The least amount of bacterial growth was detected in the samples obtained from gold-palladium coated grafts; whereas the highest rate of growth was found in samples of naive grafts. The superficial surgical site infection rate was 0% in gold-palladium coated, 30% in gold-coated and 100% in naive polypropylene group. The bacterial growth rate from wound cultures confirmed the superficial surgical site infection rates in all groups. Conclusion. Prosthetic graft infection with S. epidermidis can be prevented by coating the graft with gold-palladium or gold. (c) 2006 Elsevier Inc. All rights reserved.Öğe KOLESİSTEKTOMİ PLANLANAN HASTALARDA KOLELİTİYAZİSİN VE KOLESİSTEKTOMİNİN TİYOL/DİSÜLFİD DENGESİ'NE ETKİSİ(2019) Aydın, Oktay; Pehlivanlı, Faruk; Karaca, Gökhan; Daphan, Çağatay; Aydınuraz, Kuzey; Boyunağa, Akan; Neselioglu, SalimAmaç: Bu prospektif kontrollu klinik çalışmanın amacıyetişkinlerde komplike olmamış kolelitiyazisin ve buna yönelikuygulanan laparoskopik kolesistektomi ameliyatının hastalardatiyol/disülfid dengesine etkilerini araştırmaktır.Gereç ve Yöntem: Çalışmaya 18-80 yaş arası sağlıklı gönüllükatılımcılar (Kontrol grubu, n=30) ve 18-80 yaş arasındasemptomatik safra taşı tanısı konulup laparoskopikkolesistektomi planlanan hastalar (KLS grubu, n=30) alındı.Çalışmada sağlıklı gönüllülerden bir defaya mahsus ve tümhastalardan ameliyattan 1 saat önce ve ameliyattan 24 saat sonraiki kez olmak üzere 2 mL venöz kan örnekleri alındı veserumlarda tiyol/disülfid düzeyleri incelendi.Bulgular: Çalışmanın sonunda Kontrol grubunun Nativ Tiyol,Total Tiyol ve Disülfid değerleri KLS grubunun ameliyat öncesiölçülen değerlerine göre daha yüksek bulundu (p<0.001). KLSgrubuna ait ameliyat sonrası bakılan Nativ Tiyol, Total Tiyol veDisülfid değerlerinin Kontrol grubuna göre düşük olduğu tespitedildi (p<0.001). Ayrıca Kontrol grubunda Disülfid/Nativ Tiyolve Disülfid/Total Tiyol oranları KLS grubu ameliyat sonrasıdeğerlerine kıyasla daha yüksek ve Nativ Tiyol/Total Tiyol oranıdaha düşük olarak ölçüldü. Diğer yandan KLS grubununameliyat öncesi ve ameliyat sonrası laboratuvar değerleriarasında da farlılık olmadığı görüldü.Sonuç: Bu sonuçlarla kolelitiyazis hasta grubunda hem ameliyatöncesi hem de ameliyat sonrası doğal tiyol, toplam tiyol, disülfidseviyelerinin düşük olması kolelitiyazis kaynaklı oksidatif stresnedeniyle bu bileşiklerin bu hastalarda tüketildiğini düşündürdü.Diğer yandan bu hastalarda oksidatif metabolizmada olan budeğişikliklerin safra kesesinde taş oluşumunu provakeedebileceği de düşünüldü.Öğe Modifiye Radikal Mastektomi Operasyonlarında Ultrason Eşliğ inde Paravertebral Blok Uyğulamalarımız(2020) Aydın, Gülçin; Aydın, Oktay; Pehlivanlı, Faruk; Çolak, Selim; Daphan, Çağatay; Gençay, Işın; Aydınuraz, KuzeyTorakal paravertebral blok meme cerrahisinde etkili bir anestezi ve analjezi yöntemidir. Çalışmadaki amacımız modifiyeradikal mastektomi operasyonlarında ultrason eşliğinde yapılan torakal paravertebral bloğun intraoperatif opioid ihtiyacını vepostoperatif analjezi gereksinimini azalttığını göstermektir. Çalışmamıza 2017-2018 yılları arasında modifiye radikal mastektomitanısı ile torakal paravertebral blok yapılan 19 hasta retrospektif incelenerek dahil edildi. Hastaların demografik verileri, operasyonsüreleri ve intraoperatif opioid ve postoperatif ilk 24 saat analjezik gereksinimleri değerlendirildi. İstatistiksel değerlendirme SPSSfor Windows 21.0 programı ile yapıldı. p<0.05 değeri istatistiksel olarak anlamlı kabul edildi. 20-79 yaş aralığında olan hastalarınyaş ortalaması 50,89 (±15,74) idi. 3 hasta ASA I, 6 hasta ASA II ve 10 hasta ASA III idi. Vücut kitle indeksi ortalama 29,92(±3,99)idi. Operasyon süresi ortalama 129,05(±66,04) dakika idi. Hastalar TPVB yapılmayan: Grup 1 (n:10) ve TPVB yapılan: Grup 2(n:9): olarak 2 gruba ayrıldı. Gruplar arasında hastaların yaş ortalaması ve operasyon süreleri açısından fark yoktu. Grup 1’deki tümhastaların opioid ihtiyacı oldu. 2 hastada Remifentanil infüzyonu, 4 hastada Fentanil 100 mg ve 4 hastada ise 150 mg Fentanilihtiyacı oldu. Grup 2’de ise hiç opioid ihtiyacı olmadı. Bu durum istatistiki olarak da anlamlıydı (p<0.005). Postoperatif dönemdeGrup 1’deki hastaların tümünün analjezik gereksinimi oldu. 5 hastanın Contramal 60 mg 3*1, 5 hastanın da Contramal 60 mg 4*1ihtiyacı oldu. Grup 2’deki hastalarda hiç analjezik ihtiyacı olmadı. Bu durum istatistiki olarak da anlamlı idi (p<0.005). Modifiyeradikal mastektomi olgularında ultrasonografi eşliğinde yapılan torakal paravertebral blok ile intraoperatif dönemde opioidgereksinimi olmazken postoperatif ilk 24 saate analjeziğe ihtiyaç olmamaktadır.
