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Öğe Deneysel karın içi yapışıklık modelinde aktive timokinon’un karın içi yapışıklık üzerine etkileri(Kırıkkale, 2014) Saygun, Oral…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 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 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 The Effects of Simvastatin on Ischemia Reperfusion Injury in an Experimental Colon Anastomosis Model(Springer India, 2017) Akarsu, Mahmut; Saygun, Oral; Aydinuraz, Kuzey; Aydin, Oktay; Daphan, Cagatay Erden; Tanrikulu, Fatma Benli; Comu, Faruk MetinAnastomotic leakage is more frequently reported in colonic anastomoses. Ischemia reperfusion injury is one of the main reasons for anastomotic leakage. Simvastatin is known to prevent tissue damage induced by free oxygen radicals after ischemia reperfusion injury. The effect of simvastatin on colonic anastomosis impaired by ischemia reperfusion injury is investigated. Single layer, end-to-end colocolic anastomosis after 0.5-cm colon resection was performed in Wistar Albino rats. In Group 1 (control) (n= 10), colonic anastomosis without I-R was performed. In Group 2 (n = 10), the superior mesenteric artery was clamped for 10 min followed by 60 min of reperfusion after which resection anastomosis was performed. In Group 3 (n= 10), 10 mg/kg simvastatin was given by gavage for 7 days after I-R and resection anastomosis. In Group 4 (n = 10), the rats received 10 mg/kg simvastatin by gavage 7 days before and 7 days after ischemia reperfusion and surgery. All of the rats were sacrificed 8 days after surgery. Anastomotic bursting pressure and tissue hydroxyproline levels were measured. Postoperative administration of simvastatin restored the anastomotic bursting pressure and hydroxyproline levels to that of control group thus overcoming the effect of ischemia reperfusion injury. Simvastatin administered postoperatively in an experimental model of colonic resection anastomosis impaired by ischemia reperfusion injury increased anastomotic bursting pressures and tissue hydroxyproline levels. Further experimental and clinical studies will show whether administration of simvastatin will increase reliability of the anastomosis and decrease postoperative morbidity and mortality in colonic anastomosis after ischemia reperfusion injury.Öğe The Effects of Thymoquinone (Kalonji) on Abdominal Adhesion in Experimental Abdominal Adhesive Model(SPRINGER INDIA, 2020) Ozden, Huseyin; Saygun, Oral; Daphan, Cagatay E.; Aydinuraz, Kuzey; Aydin, Oktay; Tanrikulu, Fatma Benli; Dom, SedatThe aim of this study was to investigate the effects of thymoquinone on abdominal adhesion development in an experimental abdominal adhesion model. Forty-five female Wistar albino rats weighing 260-280 g were used in the study. The rats were randomized into 3 even groups. Control, serum physiological (SP), and thymoquinone (TQ) groups were formed. In the experimental abdominal adhesion model, caecum serosa was brushed until the petechial hemorrhages were seen. No additional procedures were performed in the control group except surgery protocol. SP was injected over the caecum in the SP group. In the thymoquinone group, the abdomen was closed after the application of prepared thymoquinone solution on the caecum surface. On the 21st day, tissue samples from sacrificed rats were examined macroscopically and microscopically, and statistically evaluated. There was a statistically significant difference between the control group and the thymoquinone group in the microscopic evaluation (p = 0.006). However, there was no statistically significant difference between SP group and control group, and between thymoquinone group and SP group. Macroscopic evaluation revealed a statistically significant difference between the thymoquinone group and the control group, and between the thymoquinone group and the SP group (p = 0.009,p = 0.027, respectively). In the microscopic and macroscopic evaluation, it was observed that thymoquinone had a decreasing effect on postoperative adhesions. We think that this effect of thymoquinone is due to its anti-inflammatory and antioxidant properties. However, the available data are not sufficient for this effect to be used in medical treatment. Further studies are needed in the future.Öğe Effects of TVE application during 70% hepatectomy on regeneration capacity of rats(Academic Press Inc Elsevier Science, 2005) Topaloğlu, Serdar; İzci, Erdal; Özel, Hakan; Topaloğlu, Eda; Avşar, Fatih M.; Saygun, Oral; Hengirmen, SüleymanBackground For adequate control of excess bleeding during liver resection, total vascular exclusion (TVE) is preferred by surgeons, especially when the tumor is located in the posterior liver lobes or near the cava. To the authors' knowledge, the effects of TVE technique on the postoperative liver regeneration process have not thus far been evaluated yet in the literature. This study was planned to compare the effects of liver resections performed either with portal pedicle clamping or with TVE on the regeneration process. Materials and methods. Seventy percent hepatectomy was performed with portal pedicle clamping (n = 10, Group A) or with TVE (n = 10, Group B) in rats. At 48 h after resection, sampling was performed for the measurement of serum transaminase, alkaline phosphatase (ALP), tissue malondialdehyde (AIDA), and glutathione (GSH) levels. Liver regeneration rate, proliferating cell nuclear antigen (PCNA) labeling, and mitotic indices were also evaluated. Results. Liver injury determinants (serum transaminases, ALP, and tissue MDA levels) were found significantly higher in group B than in group A. Liver regeneration rate, liver GSH levels, PCNA labeling index, and mitotic index were significantly lower in group B than in group A. Conclusions. The injury during TVE seems to be greater than during resection with portal pedicle clamping. The negative effect of this oxidative damage may influence the regenerative capacity of the remnant liver tissue. (c) 2004 Elsevier Inc. All rights reserved.Öğe Evaluation of liver damage after application of TVE in the rat model(Elsevier Science Inc, 2005) Darılmaz, Gökhan; Topaloğlu, Serdar; Topaloglu, E; Özel, Helin; Saygun, Oral; Avşar, Fatih Mehmet; Hengirmen, SüleymanIntroduction. The aim of this study was to investigate the effects of total vascular exclusion (TVE) on the liver during the early period of reperfusion. Materials and methods. Forty Wistar-Albino rats were divided into four groups. Portal pedicle clamping (groups 1 and 2) or TVE (groups 3 and 4) were applied for 10 minutes. Samples were collected at the time of clamp release (groups 1 and 3) and at 30 minutes of reperfusion (groups 2 and 4). We examined oxidative injury to and histopathology of the liver. Results. Oxidative stress was more prominent with TVE application. Significant alterations were shown in hepatic superoxide dismutase, catalase, glutathione, and glutathione S-transferase levels. The levels of malondialdehyde and myeloperoxidase were not altered significantly. Conclusion. Inflow-outflow occlusion of the liver causes more oxidative stress compared with inflow occlusion.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 Investigation of OH-proline contents of hernia sacs in children and comparison with adults(Georg Thieme Verlag Kg, 2005) Çağlayan, Fatma; Çağlayan, Osman; Çakmak, Murat; Saygun, Oral; Somuncu, Salih; Ulusoy, Sevgi; Akman, HPurpose: One of the factors suggested to be causative in hernia formation is defective collagen metabolism. In this study, we investigated whether there is any relationship between the collagen contents of indirect hernial sacs and certain demographic and anatomic parameters. Methods: Hernial sac hydroxyproline levels were measured in 100 pediatric and 23 adult indirect inguinal hernia cases as indicators of collagen concentrations. Hydroxyproline levels were compared between boys and girls, right and left sided hernias, unilateral and bilateral cases, children and adults. Whether there was any relationship between patient age and hydroxyproline level was also investigated. Results: No difference was found between males and females (p > 0.05), right and left sided hernias (p > 0.05) or unilateral and bilateral cases (p > 0.05). Hydroxyproline levels of adults were found to be significantly higher than those of children (p = 0.000). There was also a positive correlation between age and hydroxyproline levels of boys (r = 0.285, p = 0.023). Conclusion: Although a relationship between direct inguinal hernia and collagen structure has been shown by some investigators, we were unable to point to any significant findings which would indicate such a relationship in indirect inguinal hernia cases. Further studies on hydroxyproline levels in peritoneal samples will be necessary to understand the role of peritoneal hydroxyproline levels in hernia formation.Öğe İzole Fallop Tüpü Torsiyonu(Kırıkkale Üniversitesi, 2012) Ay, Aybala Ağaç; Aydınuraz, Kuzey; Sözen, Vural; Saygun, Oral; Daphan, Çağatay ErdenFallop tüpünün izole torsiyonu, nadir rastlanan bir akut pelvik ağrı nedenidir. Genellikle reprodüktif çağ kadın hastada sıklık gösterir, prepubertal ve postmenopozal dönemde çok nadirdir (1). Bu olguda tubal kiste bağlı olarak tubal torsiyon gelişen ve acil salpenjektomi yapılan 19 yaşında kadın hastayı sunuyoruz. Bu olgu ışığında akut karın olguları değerlendirilirken fallop tüpü torsiyonunun da akılda tutulmasının önemli olduğu görüşündeyizÖğe A rat model of polypropylene graft infection caused by Staphylococcus epidermidis(Blackwell Publishing, 2006) Ağalar, Canan; Özdoğan, Mehmet; Ağalar, Fatih; Saygun, Oral; Aydınuraz, Kuzey; Akkuş, Abdullah; Aktürk, SelçukBackground: The aim of this study was to constitute a valid graft infection model with Staphylococcus epidermidis in rats. Method: Rats were divided into seven groups. In groups 1 and 2, 2 cm x 2 cm polypropylene grafts were incubated with 10(8) c.f.u./mL slime-positive S. epidermidis at 37 degrees C for 2 and 24 h and were then placed subfascially to the groins of rats. In the third group, naive grafts were placed and 0.5 mL of 3 x 10(7) c.f.u. slime-positive S. epidermidis were injected on the inside of the wounds. Rifampicin (30 mg/kg) in group 4 and teicoplanin (20 mg/kg) in group 5 were applied i.p. to rats with 2-h incubated grafts for prophylaxis. The same prophylactic regimens were given to groups 6 and 7 in which rats were incubated for 24 h. At eighth day, rats were killed and wounds were assessed with macroscopic evaluation and cultures. Results: No death occurred in any of the groups. In groups 1 and 2, 100% infection rates were achieved. However, graft infection was detected in only two (20%) of the rats in group 3 (P = 0.001). Prophylactic application of teicoplanin or rifampicin decreased the infection rates significantly in the short-incubation groups. Conclusion: Incubation of polypropylene grafts with slime-producing S. epidermidis for 2 and 24 h in the pre-application period achieved the occurrence of a standardized graft infection. Prophylactic use of teicoplanin and rifampicin decreased the infection rates. We propose to use this reproducible and reliable animal model of graft infection in future studies.Öğe Reinforcement of the suture line with an ePTFE graft attached with histoacryl glue in duodenal trauma(2006) Saygun, Oral; Topaloglu, Serdar; Avsar, Fatih M.; Özel,Hakan; Hucumenoglu, Sema; Şahin, Mustafa; Hengirmen, SüleymanBackground: Most duodenal injuries are managed with primary repair, but the degree of duodenal-wall injury may threaten the integrity of the primary repair. Therefore, we evaluated whether the primary repair site could be reinforced with histoacryl glue (HAG) or HAG with an expanded polytetrafluoroethylene (ePTFE) mesh. Methods: Grade 3 duodenal injury in the second portion of the rat duodenum was chosen as a standard trauma model. Thirty-three male rats were divided into sham (n = 3), 2-layer primary repair (n = 10), 1-layer primary repair plus HAG application (n = 10) and ePTFE attached with HAG over the 1-layer primary repair site (n = 10) groups. Ten-day survival, adhesion grades and histological assessment were taken as outcome measures. Results: A significant survival advantage was identified in the group that had an ePTFE graft attached with HAG over a 1-layer repair when compared with the group that had a 2-layer primary repair. Adhesion grades were found to be particularly increased in the group that had an ePTFE graft attached with HAG over the primary repair site, moderately increased in the primary repair plus HAG application group and lower in the 2-layer primary repair group. ePTFE graft application was found to be beneficial to coverage of the HAG-dependent empty spaces in the serosal layer. Conclusions: A primary repair site after duodenal trauma or a difficult duodenal stump can be reinforced with the application of HAG or ePTFE graft implantation with HAG. © 2006 CMA Media Inc.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 effects of Ara-C, simvastatin and combo therapy on energy metabolism of HL-60 promyolocytic leukemia cell lines(Turkish Biochemistry Society, 2013) Boyuna?a, Hakan; Günnur Dikmen, Z.; Kenar, Levent; Saygun, Oral; Keleş, Hatice; Ugur Ural, Ali; Lale, MustafaObjective: Cancer cells choose their metabolic pathway depending on the oxygen content and substrate concentration of the medium. A wide spectrum of therapeutic agents regulating the energy metabolism of cancer cells are in still in use. Cytosine arabinoside (Ara-C) is a pyrimidine analogue used in the treatment of acute myeloid leukemia (AML) and simvastatin is an inhibitor of HMG-CoA (3-hydroxy-3-methyl-glutaryl-CoA) reductase, which regulates cholesterol biosynthesis. Thus, this study aimed to assess the energy metabolism of HL-60 promyelocytic leukemia cells and healthy white blood cells, additionally to determine the effects of simvastatin and Ara-C, alone or in combination on the energy metabolism of these cells. Materials and Methods: Healthy white blood cells, untreated and treated HL-60 promyolocytic leukemia cell lines were incubated for 4 hours with radiolabelled glucose. Following incubation, lactate, which is one of the end products of the carbohydrate catabolism, and radiolabelled CO2 produced by cells were collected and measured by the liquid scintillation device. In addition, glycogen consumption per hour was determined in each group. Results and Conclusion: We found that untreated HL-60 promyolocytic cells use anaerobic glycolytic pathway whereas healthy white blood cells use aerobic glycolysis for energy gain. It was concluded that combined use of Ara-C and Simvastatin might lead to significant increase in the rate of aerobic glycolysis of HL-60 promyelocytic cells and the metabolism of these leukemia cells become more similar to the metabolism of healthy white blood cells which they originate from. © TurkJBiochem.com.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.
